UNITED STATES. Florida: Olympic medalist Tori Bowie passed away from eclampsia following childbirth, according to an autopsy report
Tori Bowie, a three-time Olympic medalist, passed away at the age of 32 in early May while eight months pregnant and in labour at her Florida home, her agent announced on Monday, reiterating the urgency of the nation’s maternal mortality issue.
As per an autopsy report from the Orlando medical examiner’s office, Bowie might have experienced respiratory difficulties and eclampsia. According to the medical examiner, the girl child she was carrying was stillborn.
Dr Alison Cowan, an OB-GYN and the chief of medical affairs for the health technology startup Mirvie, says that Tori’s death “exemplifies so many aspects of the challenges we face today in maternal health in the US.”
Dr Cowan said that the fact that a young woman in the prime of her life and in excellent physical condition lost both her life and her unborn child to a possibly curable pregnancy-related issue truly says it all.
Although we can’t be certain of the details of her situation, this is a crucial time for us to pause and consider how we might more widely spread awareness for this possibly extremely preventable consequence, Dr Cowan added.
More women die during or shortly after giving birth in the United States than in any other developed nation, and the risks are notably higher for women of colour. Black women are at least three times more likely than white women to die during pregnancy, according to the Centres for Disease Control and Prevention.
The National Institutes of Health state that even healthy women who become pregnant can experience issues. A pregnancy-related death can happen at any moment, including during pregnancy, upon delivery, and even up to a year after birth, according to the CDC.
Here are some critical and potentially life-threatening complications that might occur during labour to be aware of:
According to the Cleveland Clinic, eclampsia is a disorder that causes shaking, confusion, and disorientation during pregnancy.
The major risk factor for eclampsia is preeclampsia, which occurs when a pregnant woman has high blood pressure and protein in her urine.
Other people who are at higher risk include those who already have high blood pressure outside of pregnancy, those who have experienced preeclampsia in a previous pregnancy, and those who have a history of diabetes, says Dr. Cowan.
There are many women, potentially including Tori Bowie, who have no known risk factors for preeclampsia. So the first step is for women to speak with their healthcare professional about their specific risk, according to Cowan.
Preeclampsia and eclampsia are both rare yet dangerous conditions. Preeclampsia, if left untreated, can cause serious – even deadly – consequences for both the mother and the baby, according to the Mayo Clinic.
According to the Cleveland Clinic, eclampsia affects less than 3% of those with preeclampsia. According to studies, black women in the US are more likely to experience birth-related problems, including preeclampsia.
As per Cowan, in the United States, black women are known to die at a rate that is roughly three times that of white women; additionally, they are thought to die from preeclampsia and eclampsia at a rate that is five times that of white women. She said that therefore, they are suffering disproportionately from sickness.
Allyson Felix, a member of Bowie’s Olympic squad, was also diagnosed with severe preeclampsia at 32 weeks pregnant. Felix had an urgent C-section, which might have saved her life.
Cowan advises women who are contemplating pregnancy or who are already expecting to fully understand their risk factors and to take appropriate action by working with their doctor to develop a strategy. She works at Mirvie and is working on a blood test that can help predict preeclampsia and other pregnancy complications.
The CDC estimates that heart disease and stroke complications are the main causes of more than 34% of all pregnancy-related deaths, making them the leading causes of mortality both during and after pregnancy.
“Many women may mistake their stroke symptoms, including headaches, dizziness, or tingling arms, for issues related to pregnancy and a new baby. If your symptoms appear suddenly, that may be a clue that you are having a stroke,” reads the organisation’s website.
The symptoms could include severe headaches, abrupt numbness, confusion, vision problems, and trouble walking. The CDC emphasises that although stroke during pregnancy is infrequent, it does increase the risk for women.
The risk of stroke during pregnancy and delivery is increased by preeclampsia, gestational diabetes, high blood pressure during pregnancy, and blood clots.
Another illness that poses a life-threatening risk is postpartum hemorrhage, or PPH, which is severe vaginal bleeding following childbirth.
“Postpartum hemorrhage is when the total blood loss is greater than 32 fluid ounces after delivery, regardless of whether it’s a vaginal delivery or a C-section, or when bleeding is severe enough to cause symptoms of too much blood loss or a significant change in heart rate or blood pressure,” according to the Cleveland Clinic’s website. The sharp drop in blood pressure can hinder blood flow to the brain and other organs.
Although postpartum hemorrhage can happen to anybody after giving birth, risk factors for it can include preeclampsia or high blood pressure, anaemia, obesity, and older maternal age.
The Cleveland Clinic estimates that it happens in one percent to ten percent of pregnancies and that roughly forty percent of those cases include women who did not have any risk factors.
Racial differences in maternal mortality
The Centres for Disease Control and Prevention reported that in 2021, during the COVID-19 epidemic, more than 1,200 American women lost their lives during pregnancy or soon after giving birth, reaching a six-decade high. According to studies, women who are unvaccinated face higher risks.
Maternal mortality rates for non-Hispanic Black women in the United States were 55.3 deaths per 100,000 live births in 2020, according to the CDC, which is approximately 2.9 times higher than the rate for non-Hispanic White women.
In a July 2022 interview with a media portal, Harvard’s Maternal Health Task Force director Dr Henning Tiemeier stated that figuring out the reason for racial disparities in maternal mortality is “essentially one of the biggest challenges of public health.”
“We regard this as the tip of the iceberg in terms of poor condition in women’s and Black women’s health. There are various causes for this. There appears to be, ranging from poverty to discrimination to inadequate care for this group of women,” according to Tiemeier.
Tiemeier added that “most of these deaths are preventable.” Cowan says that addressing these discrepancies and improving health outcomes requires both awareness and a personalised action plan.
“With predictive testing, we hope to assist individuals as much as possible. It will be the translation of that knowledge into action and prevention that will truly move the needle on maternal mortality,” Cowan continues.